Ces radiol. 2007, 61(2):173-179

Radiofrequency ablation of primary and secondary lung tumoursOriginal article

Kristýna Ohlídalová¹, Hynek Mírka¹, Jiří Ferda^1,2, Eva Ferdova^1,2, Jiří Klečka³, Václav Šimánek³

¹ Radiodiagnostická klinika LF UK a FN, Plzeň-Lochotín

² Oddělení nukleární medicíny FN, Plzeň-Lochotín

³ Chirurgická klinika LF UK a FN, Plzeň-Lochotín

Aim: To assess our own experience with percutaneous radiofrequency ablation (RFA) of the primary and secondary pulmonary tumours under CT guidance, with a CT or ¹⁸F-FDG-PET/CT follow-up.

Method: Nine RFA procedures were performed in eight patients within the period of 14 months. One patient underwent RFA via thoracotomy, two patients combined RFA with lung wedge-resection, and five patients underwent percutaneous RFA under CT guidance. Radiogram of the chest was performed after the procedure in all cases, early CT of the thorax within one week after RFA in seven patients to evaluate the presence of complications. Subsequent follow-up was performed using CT at 6 months after procedure. Pre-procedural ¹⁸F-FDG-PET/CT was used in three cases, follow-up ¹⁸F-FDG-PET/CT was performed in 6 cases within 12 months after RFA.

Results: No major complications were encountered. Pneumothorax occured in all cases after RFA, hemithorax drainage was necessary only in patients after thoracotomy. Developed twice, pleural effusion had to be drained only in one case. Pneumomediastinum and segmental pulmonary embolisation occured in one case each. Tumourous progression was noted on CT in three cases (within 6 months after RFA), no progression in three cases, and regression in three cases respectively. Of six ¹⁸F-FDG-PET/CT followed-up cases, five showed progression and one regression of the disease within 12 months after RFA.

Conclusion: RFA of the primary or secondary pulmonary tumours is a safe method of the last choice in cases when patient is not able to undergo radical surgery. CT is used for guidance of RFA and for early follow-up. ¹⁸F-FDG-PET/CT is more suitable for long-term follow-up since it allows not only the assessment of lesional metabolic activity but also complete restaging of the neoplastic process.

Keywords: CT, PET/CT, lung neoplazma, radiofrequency ablation (RFA)

Grants and funding:

Práce byla podpořena Výzkumným záměrem č. MSM 0021620819.

Accepted: April 15, 2007; Published: June 1, 2007  Show citation